Performance Quality Auditor II - Norfolk VA (81002 KT)
Company Name:
WellPoint-Caremore
Job Description
WellPoint is one of the nations leading health benefits companies and a Fortune Top 50 company. At WellPoint, we are working together to transform health care with trusted and caring solutions.
Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people's lives, and to take your career further than you can imagine.
_Performance Quality Auditor II - Norfolk VA (81002 KT)_
Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.
Primary duties may include, but are not limited to:
Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.
Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.
Tracks and trends audit results, providing feedback to management. Identifies and reports on systemic issues which create ongoing quality concerns.
Generates monthly reports of audit findings, supports clients with issues identified and develops reports to assist management with information requested.
Produces other ad hoc reports as requested by internal and external clients.
Associates at this level conduct routine to complex audits, generally related to one or more functions on one or more systems platform for one or more lines of business.
Job Qualifications
Requires high school diploma or equivalent(GED);
3 years experience including a minimum of 1 year related experience in a quality audit capacity (preferably in healthcare or insurance sector) with consistent above target performance;
working knowledge of insurance industry and medical terminology;
detailed knowledge of relevant systems and proven understanding of processing principles, techniques and guidelines;
ability to acquire and perform progressively more complex skills and tasks in a production environment
or any combination of education and experience which would provide an equivalent background.
_WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at_ _. EOE.M/F/Disability/Veteran._
Once an offer is accepted, all external applicants are subject to a background investigation and if appropriate, drug testing. Offers of employment shall be contingent upon passing both the background investigation and drug testing (if required).
Current WellPoint associates: All referrals must be submitted through the formal associate referral process on WorkNet. Official guidelines for the associate referral program can be found in My HR.
WARNING : Please beware of phishing scams that promote work-at-home opportunities and may also pose as legitimate companies. Please be advised that a WellPoint recruiter will never ask you for a credit card or any type of payment as part of consideration for a role with our company. All of our careers require that you first complete an online application on our web site.
Job Post Date: 05/09/2014
Employer: WellPoint, Inc
Benefits: WellPoint''s Benefits
Location: VA , Norfolk
Req ID: 81002Estimated Salary: $20 to $28 per hour based on qualifications.
WellPoint-Caremore
Job Description
WellPoint is one of the nations leading health benefits companies and a Fortune Top 50 company. At WellPoint, we are working together to transform health care with trusted and caring solutions.
Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people's lives, and to take your career further than you can imagine.
_Performance Quality Auditor II - Norfolk VA (81002 KT)_
Responsible for evaluating the quality of services and interactions provided by organizations within the enterprise. Included are processes related to enrollment and billing and claims processing, as well as customer service written and verbal inquiries.
Primary duties may include, but are not limited to:
Evaluates the quality and accuracy of transactions and/or communications with providers, groups, and/or policyholders.
Identifies, documents, and reports any transaction errors or communications issues in a timely manner to ensure prompt resolution.
Tracks and trends audit results, providing feedback to management. Identifies and reports on systemic issues which create ongoing quality concerns.
Generates monthly reports of audit findings, supports clients with issues identified and develops reports to assist management with information requested.
Produces other ad hoc reports as requested by internal and external clients.
Associates at this level conduct routine to complex audits, generally related to one or more functions on one or more systems platform for one or more lines of business.
Job Qualifications
Requires high school diploma or equivalent(GED);
3 years experience including a minimum of 1 year related experience in a quality audit capacity (preferably in healthcare or insurance sector) with consistent above target performance;
working knowledge of insurance industry and medical terminology;
detailed knowledge of relevant systems and proven understanding of processing principles, techniques and guidelines;
ability to acquire and perform progressively more complex skills and tasks in a production environment
or any combination of education and experience which would provide an equivalent background.
_WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at_ _. EOE.M/F/Disability/Veteran._
Once an offer is accepted, all external applicants are subject to a background investigation and if appropriate, drug testing. Offers of employment shall be contingent upon passing both the background investigation and drug testing (if required).
Current WellPoint associates: All referrals must be submitted through the formal associate referral process on WorkNet. Official guidelines for the associate referral program can be found in My HR.
WARNING : Please beware of phishing scams that promote work-at-home opportunities and may also pose as legitimate companies. Please be advised that a WellPoint recruiter will never ask you for a credit card or any type of payment as part of consideration for a role with our company. All of our careers require that you first complete an online application on our web site.
Job Post Date: 05/09/2014
Employer: WellPoint, Inc
Benefits: WellPoint''s Benefits
Location: VA , Norfolk
Req ID: 81002Estimated Salary: $20 to $28 per hour based on qualifications.
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